Retrograde Intrarenal Surgery (RIRS)
Retrograde intrarenal surgery, a procedure which allows doctors to perform surgery inside the kidney without making an incision. This technique is carried out by using a viewing tube called a fiber optic endoscope.
RIRS is done to remove the stone by using a scope. The stone is seen through the scope which is placed through the urinary opening into the bladder and then through the ureter into the kidney. The scope is then moved up the urinary tract to a position where the stone is crushed by laser or an ultrasound probe or grabbed by small forceps.
RIRS is used for difficult to treat cases like:
* Stones too large for ESWL
* Failed previous treatments
* Patients with bleeding disorders & obesity.
* Strictures and Tumors
Benefits of RIRS
Quicker healing(Short Hospital Stay),
No pain after the surgery,
No Blood Loss,
Improved cosmetic results,
Fewer complications such as infection and adhesion.
The advantages of RIRS over open surgery include a quicker solution of the problem, the elimination of prolonged pain after surgery, and much faster recovery as with all minimal invasive treatment.
Retrograde Intrarenal Surgery (RIRS) allows the surgeon to do surgery inside the kidney without making an incision. The instrument for RIRS enters through the body’s natural opening, through the bladder and the ureter, into the kidney.
Shanti Ved Hospitals | Retrograde Intrarenal Surgery (RIRS) Animation
Shanti Ved Hospitals | Retrograde Intrarenal Surgery Video
Shock-Wave Lithotripsy (SWL)
SWL is done with a machine that can break stones from outside the body. To break the stone, focused shock waves (short pulses of high energy sound waves) are transmitted to the stone through the skin. The stone absorbs the energy of the shock waves and this breaks it into smaller pieces. The stone fragments then pass with urine (Fig. a).
Fig. a: Focused shock waves break the stones into fragments.
SWL is suitable for over 90% of all patients. However, its success depends on several factors like stone characteristics and your physical condition.
Percutaneous Nephrolithotomy (PCNL)
PNL is a surgery to remove large stones directly from the kidney. The advantage is that even very large stones are removed in a single operation. PNL is carried out under general anaesthesia. Compared to SWL and URS, PNL is more invasive and there is a higher risk of complications. The most common complications are bleeding and fever.
When should I consider PNL?
PNL should be considered when your stone is very large (bigger than 2 centimetres) and has not moved to the ureter. Your doctor may also discuss PNL as a treatment option if:
*You have more than one stone
*Your stone is very hard
URS is a type of treatment which is done with a small-calibre endoscope. URS is common, success rates are very high, and the risk of complications is low. For URS you will receive general or local anaesthesia. Once you are under anaesthesia, the doctor enters your bladder with the endoscope through the urethra without making an incision in your body. The stone is pulled out using a special “basket”
When the stone is identified, it is pulled out using a special “basket”. If the stone is too big to be removed completely, it can be fragmented using laser, ultrasound, or a pneumatic lithotripter (which works like a little jackhammer). At this point all stone fragments are removed.